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administration may require dose adjustments, possibly assisted by monitoring of plasma drug concentrations. 29 At therapeutic doses, adhd stimulants do not sufficiently activate the reward system, or the reward pathway in particular, to the extent necessary to cause persistent increases in FosB gene expression in the D1-type medium spiny neurons of the nucleus accumbens ; consequently, when taken. Lab Test Interferences, none well documented. Report to health care provider if noted and significant. "Chiral drugs: comparison of the pharmacokinetics of 11Cd-threo and L-threo-methylphenidate in the human and baboon brain". Dexmethylphenidate Extended Release: A Review of its Use in the Treatment of Attention-Deficit Hyperactivity Disorder Archived at the Wayback Machine. A large body of literature has demonstrated that such FosB induction in D1-type NAc neurons increases an animal's sensitivity to drug as well as natural rewards and promotes drug self-administration, presumably through a process of positive reinforcement. Administration may lead to addiction (39, 40).

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Over the past two decades, research has progressed from identifying FosB induction to investigating its subsequent action (38). FosB overexpression in nucleus accumbens induces NFB Morton WA, Stockton GG (2000). "Methylphenidate and its ethanol transesterification metabolite ethylphenidate: brain disposition, monoamine transporters and motor activity". Park, YM; Jung,. Whereas Ritalin contains both the d and l isomers of methylphenidate, Focalin contains only the more active d-isomer. However, the recent increase of methylphenidate use as a cognitive enhancer by the general public has again raised concerns because of its potential for abuse and addiction (3, 610). 8 There are several case reports of methylphenidate inducing serotonin syndrome with concomitant administration of antidepressants.

The formation of FosB in multiple brain regions, and the molecular pathway leading to the formation of AP-1 complexes is well understood. ( edit history ) Methylphenidate is contraindicated for individuals using monoamine oxidase inhibitors (e.g., phenelzine and tranylcypromine or individuals with agitation, tics, or glaucoma, or a hypersensitivity to any ingredients contained in methylphenidate pharmaceuticals. Placebo-controlled trials have shown that once-daily dexmethylphenidate XR was effective and generally well tolerated. It also should not be used during treatment with monoamine oxidase inhibitors, or within a minimum of 14 days following discontinuation of a monoamine oxidase inhibitor. Prim Care Companion J Clin Psychiatry.

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